Development and exacerbation of autoimmune hemolytic anemia following COVID-19 vaccination: A systematic review |
| |
| Authors: | Abdollah Jafarzadeh Sara Jafarzadeh Mohammad Pardehshenas Maryam Nemati Seyed Mohammad Javad Mortazavi |
| |
| Affiliation: | 1. Department of Immunology, School of Medicine, Kerman University of Medical Sciences, Kerman, Iran;2. Student Research Committee, School of Medicine, Kerman University of Medical Sciences, Kerman, Iran;3. Department of Microbiology, School of Medicine, Kerman University of Medical Sciences, Kerman, Iran;4. Immunology of Infectious Diseases Research Center, Research Institute of Basic Medical Sciences, Rafsanjan University of Medical Sciences, Rafsanjan, Iran Department of Haematology and Laboratory Sciences, School of Para-Medicine, Kerman University of Medical Sciences, Kerman, Iran;5. Department of Medical Physics and Engineering, Shiraz University of Medical Sciences, Shiraz, Iran |
| |
| Abstract: | Autoimmune hemolytic anemia (AIHA) is caused by the production of autoantibodies against RBCs. COVID-19 vaccines can reduce the risk of severe disease, however, various adverse effects such as AIHA were observed following vaccination. This review aimed to assess the relationship of AIHA and COVID-19 vaccination using the PRISMA guidelines. Among 18 cases included in this review, new post-vaccination AIHA development was reported in 11 patients (7 women and 4 men) with a median age of 67.0 years. In 7 of 11 and 3 of 11 cases, the onset of symptoms occurred after first and second vaccine dose with median times of 7 and 14 days, respectively. In 1 of 11 cases, the AIHA occurred on Day 17 after booster vaccination. Ten of 11 and 1 of 11 AIHA patients received mRNA- and vector-based vaccine, respectively. After vaccination, 9 of 11, 1 of 11, and 1 of 11 AIHA patients developed warm IgG, cold IgM, and mixed autoantibodies against RBCs, respectively. Significant AIHA exacerbation was reported in seven patients (four women and three men) with a median age of 73.0 years. In 4 of 7 and 2 of 7 exacerbated AIHA cases, the onset of symptoms occurred after first and second vaccine dose with median times of 7 and 3 days, respectively. In 1 of 7 exacerbated AIHA cases, the onset of symptoms was observed on Day 2 after booster vaccination. All exacerbated AIHA cases received mRNA-based vaccines; 3 of 7 and 4 of 7 exacerbated AIHA cases developed IgG and IgM against RBCs, respectively. This review provides a comprehensive explanation regarding the AIHA development and exacerbation after COVID-19 vaccination. |
| |
| Keywords: | autoimmune hemolytic anemia COVID-19 SARS-CoV-2 vaccination |
|
|
